doi:10.3900/fpj.3.3.175.e
EISSN 1676-5133
GDLAM’S protocol of functional
autonomy evaluation
Original Article
Estélio Henrique Martin Dantas,
PROCIMH – Universidade Castelo Branco / RJ - Brasil
LABIMH – UCB / RJ
Grupo de Desenvolvimento Latino-Americano para Maturidade - GDLAM
Bolsista de Produtividade em Pesquisa – CNPq
[email protected]
Rodrigo Gomes de Souza Vale
PROCIMH – Universidade Castelo Branco / RJ - Brasil
LABIMH – UCB / RJ
Grupo de Desenvolvimento Latino-Americano para Maturidade – GDLAM
[email protected]
DANTAS, E.H.M., VALE, R.G.S. GDLAM’S protocol of functional autonomy evaluation. Fitness & Performance Journal, v.3, n.3, p.
175-182, 2004.
Abstract: The present study had the aim to establish a functional autonomy evaluation protocol throughout tests related with the
realization of the activities of daily living (ADL). The sample was formed of 275 old women (`C = 66.33 ± 4.69 years old), voluntaries and independent on the ADL. Tests of functional autonomy evaluation protocol by Latin-American Development to the Maturity
Group (GDLAM’S Protocol) were used. GDLAM’S Protocol was formed for C10m, LPS, LPDV and LCLC tests. The statistical analysis
made by Quartiles established the autonomy GDLAM index (IG). The IG showed scores classified on poor (+28.54), regular (28.5425.25), good (25.24-22.18) and very good (-22.18). The study admitted the level of p<0.05 for statistic significance.
Keywords: functional autonomy, old, ADL.
Correspondence to:
LABIMH – Av Salvador Allende, 6700 – Recreio dos Bandeirantes – Rio de Janeiro – RJ – CEP 22780-160
Submitted: November / 2003
Accepted: December / 2003
Copyright© 2004 por Colégio Brasileiro de Atividade Física, Saúde e Esporte
Fit Perf J
Rio de Janeiro
3
3
175-182
May/Jun 2004
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RESUMO
RESUMEN
Protocolo GDLAM de avaliação da autonomia funcional
Protocolo GDLAM de evaluación de la autonomia funcional
O presente estudo teve como objetivo estabelecer um protocolo de avaliação
da autonomia funcional através de testes relacionados com a realização das
atividades da vida diária (AVD). A amostra foi constituída de 337 mulheres idosas
(C =66,33±4,69 anos), voluntárias e independentes das AVD. Foram utilizados
os testes do protocolo de avaliação da autonomia funcional do Grupo de Desenvolvimento Latino-Americano para a Maturidade (Protocolo GDLAM), constituídos
de caminhar 10m (C10m), levantar-se da posição sentada (LPS), levantar-se da
posição decúbito ventral (LPDV) e levantar-se da cadeira e locomover-se pela
casa (LCLC). O tratamento estatístico feito por meio de Quartis possibilitou estabelecer o índice GDLAM de autonomia (IG). Este apresentou escores classificados
em fraco (+28,54), regular (28,54-25,25), bom (25,24-22,18) e muito bom
(-22,18). O estudo admitiu o nível de p<0,05 para a significância estatística.
El presente estudio hubo como objetivo establecer un protocolo de evaluación
de la autonomía funcional a través de testes relacionados con la realización
de las actividades de la vida diaria (AVD). La muestra fue constituida de 337
mujeres ancianas (C = 66,33 ± 4,69 años), voluntarias y independientes de las
AVD. Fueron utilizados los testes de lo protocolo de evaluación de la autonomía
funcional del Grupo de Desenvolvimiento Latino-Americano para la Madurez (Protocolo GDLAM) constituidos de caminar 10m (C10m), levantarse de la posición
asentada (LPS), levantarse de la posición decúbito ventral (LPDV) y levantarse
de la silla y moverse por la casa (LCLC). El tratamiento estadístico echo por el
medio de Quartil posibilitó establecer el índice GDLAM de autonomía (IG). Este
presentó escores calificados en flaco (+ 28,54) regular (28,54 – 25,25), bueno
(25,24 – 22,18) y muy bueno (-22,18). El estudio admitió el nivel de p < 0,05
para la significación estadística.
Palavras-chave: autonomia funcional, idoso, AVD.
Palabras clave: autonomía funcional, ancianas, AVD.
INTRODUCTION
Life expectancy is increasing and aging population is occurring in
almost all countries of the world, mainly in developing countries
(IBGE, 2000). And what is wanted for be human is that it is independent in their daily activities and their decisions, that means,
to live longer with quality and autonomy.
The process of aging varies widely between people and is influenced by both the lifestyle as by genetic factors (NIEMAN, 1999).
Here, the operational autonomy, or also known as functional
capacity, is one of the most important concepts in relation to
health, fitness and quality of life.
To study these concepts, a group of researchers of the Laboratory
of Human Motricity Biosciences of the Castelo Branco Universityy
(LABIMH), formed by teachers and students of the Master’s Degree
course on this institution, founded the Group of Latin American
Development for the Maturity (GDLAM ). This is characterized as
muscle functions, and can be, as Posner et al. (1995), a major
loss with advancing age.
Recent polls indicate that the elderly can benefit from exercises
not only increasing the strength and muscle strength, but also the
balance and mobility. This can reduce the risk of falls and injuries,
improving operational autonomy (ACSM, 2003; FLECK; FIGUEIRA
JÚNIOR, 2003; FRONTERA; BIGARD, 2002; MATSUDO, 2002).
For the ACSM (2003), the muscle ability may make it possible to
complete the activities of daily life with lesser effort and extend
the functional independence by allowing living the last years in a
self-sufficient and worthy way.
Thus, this study aimed to standardize a protocol for the evaluation
of functional autonomy, called Protocol GDLAM through a battery
of tests related to the implementation of the activities of daily life
(AVD) in elderly women.
an Organization of Civil Society in the Public Interest (OSCIP)
legally constituted and protocoled with registration No. 11624,
MATERIALS AND METHODS
11/05/2004.
According to GDLAM, autonomy is defined in three ways: auto-
Sample
nomy of action-referring to the notion of independence physics;
The sample was made up of older volunteer women’s, apparently healthy, from social groups of the elderly, residents in
the Região dos Lagos, in the Norte Fluminense region and
autonomy of will - referring to the possibility of self-determination
and autonomy of thoughts, which allows the judgment of any individual situation. It can be concluded that autonomy can not be
defined in only one aspect, a single angle or perspective, but in
Figure 1 - Autonomy Scheme (GDLAM, 2004)
a holistic context (Figure 1). On the other hand, the same group
defines independence as the training tasks without help, whether
of people, devices or systems (GDLAM, 2004).
Therefore, autonomy is linked to the decline in the ability to perform activities of daily life (AVD), and the gradual reduction of
176
Fit Perf J, Rio de Janeiro, 3, 3, 176, May/Jun 2004
West Zone of the State of Rio de Janeiro and Maceió, in the
state of Alagoas.
The volunteer passed by a medical evaluation and signed the
term of participation consent, in accordance with Resolution
196/96 of the National Council of Health. The study had its
project taken before the search and approved by the Committee
of Ethics in Research involving Human Beings the Castelo Branco
University, RJ.
As a criterion for inclusion, individuals of the sample should be female, have 60 years of age or over, be physically able to perform a
battery of tests selected for the evaluation of functional autonomy,
It was considered an exclusion criteria for any type of acute or
chronic condition that could jeopardize or that become a factor
of impediment to the realization of the tests.
Procedures
The tests were used to evaluate the protocol of operational
autonomy of the Group of Latin American Development for the
Maturity (GDLAM), made to walk 10m (C10m), up from the sitting
position (LPS), lifting, decubitus position of the ventral (LPDV) and
up to the chair and walk around by the house (LCLC). These tests
are described below:
•
Walking 10 meters (C10m) - the purpose of this test is to
evaluate the speed that the individual takes to go the distance
of 10 meters (SIPILÄ et al., 1996) (Figures 2 and 3).
and be independent in the performance of daily physical activities.
2
3
4
6
5
Fit Perf J, Rio de Janeiro, 3, 3, 177, May/Jun 2004
Figure
Figure
Figure
Figure
Figure
Figure
2
3
4
5
6
7
-
C10m (initial phase)
C10m (final phase)
LPS (Initial and final phases)
LPS (intermediary phase)
LPDV (initial phase)
LPDV (final phase)
7
177
Figure 8 - LCLC (initial and final phases)
The IG was calculated by a process of standardization between
the four tests of autonomy, to estimate a value in scores. This
calculation was prepared by the proposed formula below:
Where:
C10m, LPS, LPDV e LCLC = time in seconds.
IG = GDLAM indices in scores.
INSTRUMENTS
As tools for assessment of the tests were adopted: a stopwatch
(Cásio, Malaysia), a measure tape (Sanny, Brazil), a mattress
and a chair with 50 cm of height from the seat to the ground.
RESULTS
•
Lifting from the sitting position (LPS) - the test aims to assess
the functional capacity of the lower end and consists of: the
individual, based on the sitting position in a chair without
arm support, and the seat at a distance from the ground of
50 cm, raises up and takes a seat five times, consecutively
(GURALNIK et al., 1994, 1995; 2000) (Figures 4 and 5).
Lift from the ventral decubitus position (LPDV) - the purpose of
this test is to assess the ability of the individual to get up the floor.
The test consists of: from the starting position in ventral decubitus,
with arms along the body, the command of “now”, the individual
must get up, leaving the position as soon as possible (Alexander
et al., 1997) (Figure 6 and 7).
Lifting the chair and walk by the house (LCLC) - the objective is to
assess the ability of the elderly in their agility and balance in life
situations. With a chair fixed on the ground, should be demarked
two cones diagonally to the chair, at a distance of four meters
behind and three meters for the right and left sides of the same.
The individual begins the test seated in the chair, with his feet
off the floor, and with the sign “already,” he gets up, goes to the
right, moves around the cone, returns to the chair, seat down, take
both feet off the ground. Without hesitating, does the same move
to the left. Immediately, realizes again the same course, to right
and left, this way making the entire journey and circulating each
cone twice, in the shortest time possible (ANDREOTTI; OKUMA,
1999) (Figures 8 and 9).
The descriptive results of the sample as to the physical characteristics of the age and body mass index (BMI) are below, in table 1.
Observing table 1, it was found that the sample is found in the
age group of elderly (BRAZIL, 1999), but does not follow a
normal distribution on the variable age. The average BMI of the
group presented a searchable index of classification considered
overweight, according to the World Health Organization (WHO).
In table 2 are the results of the distribution of normal by the method
of Kolmogorov-Smirnov.
Checking table 2, is noted that C10m, LPS, LCLC and FC had
a near normal distribution. The test LPDV did not positioned the
same way; a fact that does not de uncharacterizes data as a whole.
In table 3 are the results describing the protocol GDLAM.
Analyzing table 3, it was observed that the test LPDV was the fastest
to be executed by the sample, while the LCLC was the longest.
Figure 9 - LCLC (intermediary phase)
The times of these tests were assessed in seconds. The data were
analyzed using descriptive statistics (Mean, Standard Deviation,
Quartos) through the program “SPSS 10.0 for Windows,” to
establish a standard for the classification and a general index of
autonomy (index GDLAM-IG), as times achieved for the testing.
The study acknowledged the level of p < 0.05 for statistical
significance.
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Fit Perf J, Rio de Janeiro, 3, 3, 178, May/Jun 2004
The average was the best measure of central tendency for the
variables C10m, LCLC and IG, as the coefficient of variation (CV)
LCLC and IG, and the median for the test LPS and LPDV as the
results for the coefficient of variation-CV (table 3).
was less than 20%. The values of the medians were coming to
the values of the medium. The standard deviations are presented
DISCUSSION
in a satisfactory manner.
In Table 4 are the results of the tests classified in the times achieved
by the sample.
Observing table 4, it was found that this classification can be a
parameter for assessing the autonomy of the protocol GDLAM,
and be used as a standard reference for many studies in this area
of research.
In Table 5 are given ratings of the assessment of the autonomy,
through the protocol GDLAM, obtained through quarters.
Analyzing table 5, it was found that the categorization of the times
achieved by the sample, made by the statistical quarter procedure,
enabled classification into categories for each test individually,
and standardization in scores of the IG of autonomy, both at:
weak, regular , good and very good. For the applicability of this
classification, it is recommended to use the average for C10m,
In Picture 1 are exposed the results of studies on the operational
autonomy, to the activities of daily life (AVD).
Classifying the results of the studies presented in Table 1, according
to table 5, it was found that for the C10m test, surveys of Valley
(2004), in the control group, and Pernambuco et al. (2003) showed that the times achieved were regarded as weak, while work
on Geraldes (2000), Valley et al. (2003 a, 2003b, 2004) and
Varejão et al. (2004) obtained classified times as very good. In
other studies, the results were in intermediate standings.
Differences on these times may be justified by the type of intervention proposed for each sample. But the times achieved are
considered satisfactory for an old man crossing a street safely.
In the LPS test, the group that did not undergo the intervention
study of Valley (2004), the group that has been evaluated at the
beginning of an experimental treatment (PERNAMBUCO et al.,
Table 1 - Characteristics of the sample (n = 337)
Variables
Average
s
Age
66.33
4.69
IMC
26.01
4.42
Median
CV
Standart error
a3
a4
66.0
7.07%
0.30
0.81
1.13
25.54
16.98%
0.28
0.44
-0.05
S = standard deviation; CV = coefficient of variation; a3 = asymmetry; a4 = curtose; BMI = body mass index.
Table 2 - Results of the normality test verification
Tests
n
Z Statistic
p-value
Distribution
C10m
337
1.253
0.087
Normal
LPS
337
1.003
0.267
Normal
LPDV
313
2.650
0.000
Not normal
LCLC
92
0.798
0.548
Normal
IG
92
0.801
0.542
Normal
C10m = walk 10 meters; LPS = raise from the sitting position; LPDV = raise from the position of ventral decubitus; LCLC = lift chair and walk by the house; IG
= index GDLAM. P < 0.05.
Table 3 - Results of the tests of the GDLAM protocol
Tests
C10m
LPS
LPDV
LCLC
IG
N
337
337
313
92
92
Average
6.45
9.77
3.78
39.26
25.73
Standart deviation
1.04
2.44
1.70
5.53
4.46
Median
6.34
9.55
3.30
38.69
25.22
16.16%
24.97%
45.03%
14.09%
17.32%
0.06
0.13
0.10
0.58
0.46
CV
Standart error
Minimum
4.03
4.89
1.64
30.10
19.02
Maximum
10.84
17.71
13.33
58.72
38.23
0.76
0.05
1.91
0.60
0.66
1.00
0.00
4.89
0.55
0.02
Asymmetry a
Curtose a
3
4
C10m = walk 10 meters; LPS = raise from the sitting position; LPDV = raise from the position of ventral decubitus; LCLC = lift from the chair and walk by the
house; IG = GDLAM index in scores.
Test times were measured in seconds.
Fit Perf J, Rio de Janeiro, 3, 3, 179, May/Jun 2004
179
2003) and the group’s study of Geraldes (2000) had times that
are located under the classification: weak. Findings of studies
Baptista et al. (2003), Baptista (2004), Valley et al. (2003 -) and
Vale (2004) showed that the execution times of testing are on
level of classification: very good. The other results of the other
surveys were distributed in other levels of classification of the
Standard Protocol GDLAM. The time marked on this test can
generate a sense of ease or difficulty that the elderly executants
can demonstrate to lift themselves from a chair, which is a very
frequent movement in daily life.
In the LPDV test, only Valley’s research (2003b) presented the
results at a level of classification: very good. This may be related
to the training of force that was used in the treatment trial. Other
studies have shown other classifications. It is important to underline that in the study of Geraldes (2000), this test was used in the
initial position of decubitus dorsal, different from other studies. This
fact provides an increase in the time of implementation, since the
elderly individual, initially, turns the body to the position of ventral
decubitus, and then get up. This test represents the movement to
lift itself from the floor or a bed.
Notice that the LCLC test was less used in the submitted studies.
But it is a test that assesses the agility and balance of the elderly
executants, becoming thus an important tool for assessing autonomy. This test was the longest of all, to be executed. No study
showed a very good level of classification. It is easy to see the
need of evaluation of it’s applicability in most polls. However,
interventions that demanded a strength work achieved better
results (VALE, 2004).
Table 4 - Classification of the times of the tests in quarters
Tests
1st Quarter
2nd Quarter
3rd Quarter
4th Quarter
C10m
> 7.09
7.09 – 6.34
6.33 – 5.71
< 5.71
LPS
> 11.19
11.19 – 9.55
9.54 – 7.89
< 7.89
LPDV
> 4.40
4.40 – 3.30
3.29 – 2.63
< 2.63
LCLC
> 43.00
43.00 – 38.69
38.68 – 34.78
< 34.78
C10m = walk 10 meters; LPS = raise from the sitting position; LPDV = raise from the position of ventral decubitus; LCLC = lift from the chair and walk by the
house; IG = GDLAM index in scores.
Test times were measured in seconds.
Table 5 - Standard of Evaluation of the Functional Autonomy of the GDLAM Protocol
C10m
(sec)
+ 7.09
LPS
(sec)
+ 11.19
LPDC
(sec)
+ 4.40
LCLC
(sec)
+ 43.00
IG
(scores)
+ 28.54
Regular
7.09 – 6.34
11.19 – 9.55
4.40 – 3.30
43.00 – 38.69
28.54 – 25.25
Good
6.33 – 5.71
9.54 – 7.89
3.29 – 2.63
38.68 – 34.78
25.24 – 22.18
- 5.71
- 7.89
- 2.63
- 34.78
- 22.18
Test classification
Week
Very good
C10m = walk 10 meters; LPS = raise from the sitting position; LPDV = raise from the position of ventral decubitus; LCLC = lift chair and walk by the house; IG
= GDLAM index.
Picture 1 - Studies on autonomy of AVD, through the GDLAM Protocol
Study (year)
Amorim, 2002
Aragão, 2002
Baptista et al., 2003
Baptista, 2004
Geraldes, 2000
Pernambuco et al., 2003
Pernambuco, 2004
Vale et al., 2003a
Vale et al., 2003b
Vale, 2004
Varejão et al., 2004
Training
Aerobic
RML
Yoga
Yoga
Strenght
Shiatsu
Shiatsu
Dynamic Flex.
Dynamic Flex.
Strength
75 – 85% Strength
Dynamic Flex.
Control
Static Flex.
Stretching
C10m
6.78
7.00
6.26
6.97
5.60
7.46
6.07
5.93
5.44
5.35
5.65
593
7.11
5.35
5.99
LPS
10.68
11.0
7.55
7.34
11.40
12.95
10.11
8.35
7.70
8.30
7.16
8.35
13.23
9.43
9.44
LPDV
3.88
4.50
2.92
2.71
4.1*
5.73
3.21
3.35
2.90
2.54
3.28
3.32
4.99
3.43
3.53
LCLC
54.12
39.17
38.72
35.76
38.35
46.31
-
C10m = walking 10 meters; LPS = raising from the sitting position; LPDV = raising from the ventral decubitus position; LCLC = lift the chair and walk over by
the house. Average = time (seconds).
* The test was conducted in dorsal decubitus. Time in seconds.
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Fit Perf J, Rio de Janeiro, 3, 3, 180, May/Jun 2004
10
13
11
Figure
Figure
Figure
Figure
Figure
10:
11:
12:
13:
14:
VTC
VTC
VTC
VTC
VTC
(initial phase Phase1)
(intermediary phase 1)
(intermediary phase 2)
(intermediate phase 3)
(final phase)
In general, when looking at table 1, it’s noted that the older
sedentary subjects (PERNAMBUCO et al., 2003; VALE, 2004)
achieved times that are situated at a level of classification: weak,
on the Standard GDLAM Protocol for all the tests performed. This
indicates that the elderly who remain physically inactive throughout
life should suffer the effects of aging with greater impact, however,
those who remain physically active tend to prolong the functional
independence and quality of life.
CONCLUSION
Considering that the operational autonomy is linked to the activities of daily life (AVD), the general index (GI) was idealized to
represent the level of this variable in the elderly. Due to the nature
of the movement and its relation to daily life, all the tests seem to
allow an overview of the elder.
Acknowledgments
As the results presented and the methodology applied, the
present study suggests the creation of one more test for the
evaluation of functional autonomy, which is linked to the movements of upper members. It points out the test of taking off
and dressing shirts (VTC), where the time to completion of the
same will be marked in seconds (Figures 10, 11, 12, 13 and
14). The lower the time of execution, the better the result. The
individual should be standing with arms along the body and a
T-shirt in one of the hands. At the sign of “already,” he should
wear the shirts and, immediately, withdraw it, returning to the
starting position. This test is intended to measure the agility and
coordination of the upper members.
It is believed that with the inclusion of the VTC, the pattern of Protocol GDLAM of functional autonomy will be more complete in its
overall assessment. That shows the attempt to establish a test that
seeks to assess a movement which tends to make an achievement
with the difficulty of aging, and that fits in AVD.
Fit Perf J, Rio de Janeiro, 3, 3, 181, May/Jun 2004
12
14
According to the findings of this research, the IG can be used as a
parameter for assessing the functional autonomy for the realization
of the AVD. Similarly, the study indicates that the pattern of Protocol
GDLAM can be applied as a reference for future investigations,
and to enter the VTC to investigate whether new standards of
reference of autonomy.
Thanks to the Masters Teachers of the line research “Physical Activity, Autonomy and Quality of Life of the Elderly” of PROCIMH
- UCB / RJ, Jani Aragon, Lilliany Lamb, Márcio Baptista, Carlos
Pernambuco, Fatima Amorim, Amândio Geraldes and Ronaldo
Varejão, who kindly gave the data for their Master’s theses, for
the preparation of this study.
REFERENCES
ALEXANDER, Neil B.; ULBRICH, Jessica; RAHEJA, Aarti; CHANNER, Dwight. Rising from
the floors in older adults. Journal of the American Geriatrics Society. v. 45, n. 5, p.
564−569, 1997.
AMERICAN COLLEGE OF SPORTS MEDICINE. Diretrizes do ACSM para os testes de
esforço e sua prescrição. 6ª edição. Rio de Janeiro: Guanabara Koogan, 2003.
AMORIM, Fátima S. Efeitos do treinamento da capacidade aeróbica sobre a qualidade de vida e autonomia de idosos. 2002, 231 f. Dissertação (Mestrado em Ciência
da Motricidade Humana). Universidade Castelo Branco - UCB. Rio de Janeiro.
ANDREOTTI, Rosana A.; OKUMA, Silene S. Validação de uma bateria de testes de atividades
da vida diária para idosos fisicamente independentes. Revista Paulista de Educação
Física, v. 13, n. 1, p. 46-66, 1999.
ARAGÃO, Jani Cleria Bezerra de. Efeitos da resistência muscular localizada visando
a autonomia e a qualidade de vida de idosos. 2002, 332 f. Dissertação (Mestrado
em Ciência da Motricidade Humana). Universidade Castelo Branco - UCB. Rio de Janeiro.
BAPTISTA, Márcio Rodrigues. A prática do yoga sobre a autonomia funcional e
qualidade de vida em mulheres senescentes. 2004, 325 f. Dissertação (Mestrado
em Ciência da Motricidade Humana). Universidade Castelo Branco - UCB. Rio de Janeiro.
181
BAPTISTA, Marcio R.; VALE, Rodrigo G. S.; PERNAMBUCO, Carlos S.; DANTAS, Estélio
H. M. O yoga na autonomia funcional em mulheres senescentes. In: XXVI SIMPÓSIO
INTERNACIONAL DE CIÊNCIAS DO ESPORTE, São Paulo, 2003. Anais: Atividade física
construindo saúde. Edição esp. Revista Brasileira de Ciência e Movimento, p. 82, 2003.
MATSUDO, S. M. M. Envelhecimento, atividade física e saúde. Revista Mineira de
Educação Física, v. 10, n. 1, p. 193-207, 2002.
BRASIL. Ministério da Saúde. Resolução 196/96. O Plenário do Conselho Nacional de
Saúde resolve aprovar diretrizes e normas regulamentadoras de pesquisas envolvendo
seres humanos. Em 10 de outubro de 1996.
PERNAMBUCO, Carlos S.; VALE, Rodrigo G. S.; BAPTISTA, Marcio R.; ABREU, Flávia M. C.;
DANTAS, Estélio H. M. Perfil da autonomia funcional de idosos no ingresso de um programa de shiatsuterapia no município de Araruama. In: XXVI SIMPÓSIO INTERNACIONAL
DE CIÊNCIAS DO ESPORTE, São Paulo, 2003. Anais: Atividade física construindo saúde.
Edição esp. Revista Brasileira de Ciência e Movimento, p. 78, 2003.
BRASIL. Ministério da Saúde. Portaria nº 1395/GM. Dispõe sobre a POLÍTICA NACIONAL
DE SAÚDE DO IDOSO. Em 10 de dezembro de 1999.
FLECK, S. J.; FIGUEIRA JÚNIOR, A. Treinamento de força para fitness e saúde. São
Paulo: Phorte Editora, 2003.
FRONTERA, W. R.; BIGARD, X. The benefits of strength training in the elderly. Science
and Sports, v. 17, i 3, p. 109-116, May, 2002.
NIEMAN, D. C. Exercício e saúde. 1ª edição. São Paulo: Manole, 1999.
PERNAMBUCO, Carlos S. Comparação de um programa de shiatsuterapia e de um
programa de flexionamento dinâmico na flexibilidade, na autonomia e qualidade de vida do idoso. 2004, 177 f. Dissertação (Mestrado em Ciência da Motricidade
Humana). Universidade Castelo Branco - UCB. Rio de Janeiro.
GERALDES, A. A. R. Efeitos do treinamento contra resistência sobre a força muscular
e o desempenho de habilidades funcionais selecionadas em mulheres. 2000,
214f. Dissertação (Mestrado em Ciência da Motricidade Humana), Universidade Castelo
Branco, UCB. Rio de Janeiro.
POSNER, Joel D.; MCCULLY, Kevin K.; LANDSBERG, Lisa A.; SANDS, Laura P.; TYCENSKI,
Patricia; HOLFMANN, Mary T.; WETTERHOLT, Kristina L.; SHAW, Carl E. Physical determinants of independence in mature women . Archive of Physical Medicine and
Rehabilitation, v. 76, p. 373−380, 1995.
GRUPO DE DESENVOLVIMENTO LATINO-AMERICANO PARA MATURIDADE (GDLAM).
Discussões de estudo: conceitos de autonomia e independência para o idoso.
Rio de Janeiro, 2004.
SIPILÄ, S.; MULTANEN, J.; KALLINEN, M.; ERA, P.; SUOMINEN, H. Effects of strength and
endurance training on isometric muscle strength and walking speed in elderly women.
Acta Physiologica Scandinavica, v. 156, p. 457-464, 1996.
GURALNIK, Jack M.; SIMONSICK, Eleanor M.; FERRUCCI, Liugi; GLYNN, Robert J.; BERKMAN, Lisa F.; BLAZER, Dan G.; SCHERR, Paul A.; WALLACE, Robert B. A short physical
performance battery assessing lower extremity function: association with self-reported
disability and prediction of mortality and nursing home admission. The Journal of Gerontology, v. 49, n. 2, p. M85−M94, 1994.
VALE, R. G. S.; ARAGÃO, J. C. B.; DANTAS, E. H. M. A flexibilidade na autonomia funcional
de idosas independentes. Fitness e Performance Journal, v. 2, n. 1, p. 23-29, 2003a.
GURALNIK, Jack M.; FERRUCCI, Liugi; SIMONSICK, Eleanor M.; SALIVE, Marcel E.;
WALLACE, Robert B. Lower-extremity function in persons over the age of 70 years as a
predictor of subsequent disability. The New England Journal of Medicine. v. 332, n.
9, p. 556−561, 1995.
GURALNIK, Jack M.; FERRUCCI, Liugi; PIEPER, C. F.; LEVEILLE, S. G.; MARKIDES, K. S.;
OSTIR, G. V.; STUDENSKI, S.; BERKMAN, L. F.; WALLACE, Robert B. Lower extremity function and subsequent disability consistency across studies, predictive models and value
of gait speed alone compared with the short physical performance battery. Journal of
Gerontology. v. 55, n. 4, p. M221-M231, 2000.
INSTITUTO BRASILEIRO DE GEOGRAFIA E ESTATÍSITICA (IBGE). Base de dados, censo
2000. Disponível na Internet em: <http://www.ibge.gov.br> Acesso em 10 de março
de 2003.
182
VALE, Rodrigo G. S.; BAPTISTA, Marcio R.; PERNAMBUCO, Carlos S.; VIEIRA, Fernando R.;
ARAGÃO, Jani C. B.; DAMASCENO, Vinicius; CORDEIRO, Lilliany S.; NOVAES, Jefferson
S.; DANTAS, Estélio H. M. Treinamento resistido de força em idosas independentes. In:
XXVI SIMPÓSIO INTERNACIONAL DE CIÊNCIAS DO ESPORTE, São Paulo, 2003. Anais:
Atividade física construindo saúde. Edição esp. Revista Brasileira de Ciência e Movimento, p. 53, 2003b.
VALE, Rodrigo G. S. Efeitos do treinamento de força e de flexibilidade sobre a
autonomia e qualidade de vida de mulheres senescentes. 2004, 232 f. Dissertação
(Mestrado em Ciência da Motricidade Humana). Universidade Castelo Branco - UCB.
Rio de Janeiro.
VAREJÃO, Ronaldo V.; MELO, Roberto; BARROS, Rosilane; VALE, Rodrigo G. S.; ARAGÃO,
Jani C. B.; AMORIM, Fátima S.; DANTAS, Estélio H. M. Comparação dos efeitos do alongamento e do flexionamento ambos passivos sobre os níveis de flexibilidade, autonomia
e qualidade de vida do idoso. FIEP Bulletin, v. 74, 2004.
Fit Perf J, Rio de Janeiro, 3, 3, 182, May/Jun 2004